> I will not reach for drugs until I have done everything I can in good faith with food and meal timing This is a great approach and I don't want to discourage

> I will not reach for drugs until I have done everything I can in good faith with food and meal timing This is a great approach and I don't want to discourage it, but there's a spectrum of cystic acne. Honestly, I'm basing my comments more off personal experience (different people close to me have used Accutane), but I'm not sure how often diet is the cause of (non-simple) cystic acne, although, granted, I'm by default thinking of the more extreme cases. I had a single cyst under my cheek for a semester that dissolved on it's own - never considered Accutane for such a mild cyst. On the other hand, a close associate of mine developed severe cystic acne after being prescribed and using different birth control medicines. The symptoms not only continued, but got worse, well after ceasing these medications. No diet change was going to fix this - Accutane changed this persons life. After going to a few doctors seeking treatment, they were hesitant to prescribe Accutane to this person unless there were no other options. From what I've read online and stories I've heard from this person, this seems to be the norm - if you get prescribed Accutane (withholding doctors who jump straight to medication), you likely have a non-trivial case of acne that won't be reduced by say eating less chocolate. It's like treating depression - some people are able to solve other issues in their life that improve the depression tremendously, and other people have certain brain chemistry imbalances that make this process impossible _until_ they're treated with anti-depressants.